POS0594 FACTORS ASSOCIATED WITH THE 6-MINUTE WALK TEST AMONG PERSONS WITH RHEUMATOID ARTHRITIS
Authors: I. S. Houge, M. Hoff, V. Videm
Journal: Annals of the Rheumatic Diseases (2022)

Background Persons with rheumatoid arthritis (RA) are less physically active than the general population. A 6-minute walk test (6MWT) measures how far a person can walk in 6 minutes, testing overall functional capacity. This can inform clinicians before initiating potential interventions. Objectives To assess psychological, patient- and disease-related factors associated with 6MWT results among persons with RA. Methods Patients were recruited in 2019 and 2021 from the Rheumatology outpatient clinics at St. Olavs Hospital and Levanger Hospital, Norway (n=225). They answered questionnaires, and a subgroup (n=86) performed a 6MWT according to guidelines from the American Thoracic Society (1). Diagnostic characteristics and medical history were collected from hospital records. Participants with data for 6MWT but missing data for other variables in the main model were excluded (n=7). Physical function was measured with the Modified Stanford Health Assessment Questionnaire (mHAQ, range 0-3, lower score indicating better physical function). For the patient global assessment (PGA) patients rated their overall disease activity in the past week on a 100 mm visual analogue scale; higher score indicates more symptoms. Presence of depressive symptoms was measured with the Hospital Anxiety Depression Index Depression score (HADS-D, range 0-21, higher value implying more depressive symptoms). Perceived stress was measured with Cohen’s Perceived Stress Scale (range 0-40, higher score indicates more stress). The belief in one’s ability to be physically active under different circumstances was measured by the Self-Efficacy for Exercise score (range 5-35, higher score indicates higher self-efficacy). Data were analyzed with multiple regression with 6MWT as dependent variable. Model 1 included age (categorized into tertiles to improve model fit: &lt;59, 59-69, or ≥70 years), sex, mHAQ, PGA, HADS-D, Cohen’s Perceived Stress Scale, Self-Efficacy for Exercise, smoking habit and body mass index (BMI, categorized ≤25 or &gt;25 kg/m 2 ). Model 2 included only the variables significantly associated with 6MWT in Model 1, but keeping adjustment for sex. The regression coefficients of Model 2 were standardized. Results: Table 1. Patient characteristic Rheumatoid arthritis patients (N=79) Female sex, n (%) 60 (76) Age (years), median (IQR) 65 (55, 71) Ever smoker, n (%) 49 (62) Body mass index (kg/m 2 ), median (IQR) 26.3 (23.6, 28.9) Rheumatoid arthritis duration (years), median (IQR) 10 (5, 23) Seropositive (anti-CCP and/or RF), n (%) 68 (86) Uses conventional DMARDs, n (%) 67 (85) Uses biological DMARDs, n (%) 42 (53) Uses corticosteroids, n (%) 21 (27) Cardiovascular disease (HT, angina, MI, arrhythmia or stroke), n (%) 38 (48) Respiratory disease (COPD, CRPD or asthma), n (%) 21 (27) DAS28-CRP 2.3 (1.8, 2.9) Modified Health Assessment Questionnaire, median (IQR) 0.38 (0.13, 0.63) Patient global assessment (mm), median (IQR) 27 (12, 40) Hospital Anxiety Depression Scale Depression score, median (IQR) 3 (1, 4) Cohen’s Perceived Stress Scale, median (IQR) 15 (9, 19) Self-Efficacy for Exercise, median (IQR) 25 (17, 30) 6-Minute Walk Test (m), mean (±SD) 507 (±88) In model 1, the variables associated with 6MWT were mHAQ (p=0.04), Self-Efficacy for Exercise (p=0.001), BMI (p=0.01) and age (oldest versus youngest age tertile p&lt;0.001, middle versus youngest age tertile p=0.11). Sex was not significantly associated with 6MWT (p=0.82). The standardized coefficients in Model 2 were: mHAQ -0.27 (p=0.002), Self-Efficacy 0.27 (p=0.002), categorized BMI -0.27 (p-value=0.002), middle age group versus youngest age group -0.17 (p=0.08), oldest age group versus youngest age group -0.55 (p&lt;0.001), male gender 0.08 (p=0.33). The R 2 of Model 1 and Model 2 were 0.54 and 0.52 respectively. Conclusion Self-Efficacy for Exercise, mHAQ, BMI and age had the largest impact on 6MWT, explaining 52 % of the observed variation in 6MWT in a model adjusted for sex. References [1]ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 166(1), 111-117 (2002). Disclosure of Interests None declared